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HomeMy WebLinkAboutT14N R1W SEC 8 SW4SW4NW4T14N R1W Sec.8 5W4 5W4 NW4 #050-013-01 GAAB-HD-1 GRATER ANCHORAGE AREA BOROISH HEALTH DEPARTMENT up 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION- REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME Ate %d %S », i LOCATI ON04/ &.g& SEPTIC TANK; DISTANCE FROM WELL /JZ% MATERIAL LIQUID CAPACITY moo GALLONS. 37 4/4144/O�,E�� MAILING ADDRESS ��� PHONE C /12/1:g111 "1/8 �/ LEGAL DESCRIPTION S/2 cfbty /. 00,tle,v 7 Wet //a ct INSIDE LENGTH N IF COMPARTMENTS 'cep 7'�.v4- X Ce 5, M 1411/41 LIQUID INSIDE WIDTH DEPTH SEEPAGE SYSTEM: NUMBER. OF PITS LINING MATERIAL NEAREST LOT. LINE SEEPAGE PIT: ' .OUTSIDE DIAMETER OR WIDTH j r4 ve.� 4,0`• DISTANCE FROM WELL �,• a' LENGTH JPO DEPTH YsZ - BUILDING FOUNDATION_ - TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 3810 SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION TOTAL LENGTH NEAREST LOT LINE OF LINES NUMBER OF. LINES DISTANCE BETWEEN. LINES TRENCHWIDTH - IN TOTAL EFFECTIVE ABSORPTION AREA - SQ FT LENGTHOF EACH LINE - - DEPTH: TOP OF TILE TO FINISH GRADE �i17 DEPTH OF FILTER MATERIAL BENEATH TILE IN ABOVE TILE WELL: p /i/ - DISTANCE FROM ' in 1, WATER /1/0 TYPE .}7) e 1 LL 6,D DEPTH , BUILDING FOUNDATION fJV . SAMPLE NEAREST LOT LINE SC' t' SEWERST DNE /SD TANK /3��/SYS EM SEEPAGE /-7C,rn / CESSPOOL SOOURCES_ DISTANCES: _54ow Al DIAGRAM OF SYSTEM DATE APPROVED HEALTH AUTHORITY GRAB -HD -2 GREATEaNCHORAGE AREA *ROUGH Case No. /0/ HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT /�pp ilm/w v eF NAME OF APPLICANT ,,qq -2911 F-r�SSistit) MAILING ADDRESS &X3 7 PHONE NO 'QS // RESIDENCE ADDRESS 61-er ie I t . LOCATION OF INSTALLATION rvL -- LEGAL DESCRIPTION 5ec g /UV yz APPLICATION TO INSTALL: SEPTIC TANK V , SEEPAGE4.-'-- PITDRAIN FIELD OTHER TO SERVE THE FOLLOWING FACILITY 3 Le/2,44.7J FINANCED THROUGH 6o_f TO BE INSTALLED BY l,6ll 01d Le. PERCOLATION TEST RESULT 4/4" ANTICIPATED DATE OF COMPLETION g�-�/ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT / THIS IS TO SERVE AS PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED DISTANCES: SEPTIC TANK SIZE TYPE SEEPAGE AREA TYPE DIAGRAM OF SYSTEM Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE APPLICANTS SIGNATURE ace onstruction & Concrete Co. Phone: —St= 62 oz/L-/ Mile 19 Chugiak, Alaska re° 41A -1/ 44 6) 11: I / 1/UC Ms -maid /Joy- / fic.../24.0%. CAter-er '322 ST 111; a .41 Fr .2 gt c • 1 cage RETL: Ft%rrid r•-, etiest:c /000 144 SEPTIc 7,44/? stet", fir I/1 c 0.vcRZIk izz "1 Gk-ATER ANCHORAGE AREA BOROUGh DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: 5/8/7_ INSPECT: TIME: ,00 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR 1. APPROVAL REQUESTED BY: ADDRESS: PHONE: yr ///i v&/ /v,o4mom.) F`5 U't� 42 % 69Ll- 22 9 2. PROPERTY OWNER: diff.' PHONE:• y9a.//97EL/ 5, /77,s, ' kc 514 hili/ i STREET: , ljy/ft_ 3 o /r/ , /P, h -0a% 3 /70' —7.7 /d 7 6t t �/� 3. LEGAL DESCRIPTION: 4. TYPE FACILITY TO BE INSPECTED:f/� NUMBER OF BEDROOMS: %%// 5. WELL DATA: A. TYPE 8. DEPTH C. SIZE. D. CONSTRUCTION weft c --P ois(Glyi ol E. BACTERIAL ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 1. SIZE 2. A.GEJ /'6J Or�U "4V67/7) J 3. MANUFACTURER 4. INSTALLER ,O, / /4 7t69 M APPROVAL REQUEST—FOR SEWER & WATER FACILITIES" PAGE TWO B. SEEPAGE PIT 1. SIZE /1q)(29 vi r 2. LINING61,-n. C/ce%e ri h�ji C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LEN TH 7. REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK 190f B. WELL TO SEEPAGE PIT /30t C. WELL TO SEWER LINE D. WELL TO PROPERTY LINE E. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK G. FOUNDATION TO SEEPAGE PIT •/ H. SEEPAGE PIT TO PROPERTY LINE 2-0--+ 8. COMMENTS: StAPPROVED. ifG 1 tSW, DISAPPROVED: DATE: 3 / � 77 Z DATE: APPROVAL VA ID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY